重庆市中学生健康素养水平及影响因素分析

金凤; 刁华; 蒲杨; 唐银霜; 张菁麟; 王宏

doi:10.16835/j.cnki.1000-9817.2021.07.005

重庆市中学生健康素养水平及影响因素分析

doi: 10.16835/j.cnki.1000-9817.2021.07.005

重庆医科大学公共卫生与管理学院/医学与社会研究中心/健康领域社会风险预测治理协同创新中心, 重庆 400016

基金项目:

重庆市教育委员会人文社会科学研究项目 18SKGH016

详细信息

作者简介:
金凤(1995-), 女, 重庆市人, 在读硕士, 主要研究方向为儿童青少年卫生及疾病控制策略

通讯作者:
王宏, E-mail: wangh111111@aliyun.com

中图分类号: G478 R179
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- HTML全文浏览量: 414
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- 被引次数: 0
出版历程
- 收稿日期: 2021-01-02
- 修回日期: 2021-04-13
- 网络出版日期: 2021-07-23
- 刊出日期: 2021-07-25

Prevalence and influencing factors of health literacy among junior and senior high school students in Chongqing

School of Public Health and Management/Research Center for Medicine and Social Development, Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing (400016), China

摘要

摘要: 目的了解重庆市中学生健康素养水平及影响因素，为针对性开展健康促进工作提供依据。方法于2019年11—12月采用分层随机整群抽样方法，在重庆市4个区县抽取8 449名初、高中生进行青少年健康素养问卷调查。结果重庆市中学生总健康素养、功能性健康素养、互动性健康素养和批判性健康素养的具备率分别为67.96%(5 742名)、75.12%(6 347名)、50.24%(4 245名)和72.21%(6 101名)。12个因子素养中具备率较低的有健康决定能力、合理营养、沟通能力，具备率分别为41.52%(3 580名)、46.09%(3 894名)、62.18%(5 254名)。控制相关混杂因素后，多因素Logistic回归分析显示，调查地区(OR=1.20)、学段(OR=1.35)、与母亲关系(OR=1.52)、与老师关系(OR=2.20)、亲密朋友数量(OR=1.68)、健康教育课程(OR=1.52)是影响中学生总健康素养的因素(P值均＜0.05)。结论重庆市中学生健康素养水平较低，应重点提高互动性健康素养，促进中学生健康发展。
- 健康教育 /
- 问卷调查 /
- 回归分析 /
- 学生
Abstract: Objective To understand the health literacy level and its influencing factors among middle school students in Chongqing, and to provide a basis for health promotion. Methods Using stratified cluster random sampling and a self-designed questionnaire, we conducted a survey among 8 449 junior and senior high school students from four districts and counties in Chongqing municipality from November to December 2019. Results The attainment rates of total health literacy, functional health literacy, interactive health literacy, and critical health literacy among middle school students in Chongqing were 67.96%, 75.12%, 50.24%, and 72.21%, respectively. Among the 12 factors, low rates were observed in health decision-making, reasonable nutrition, and communication (41.52%, 46.09% and 62.18%, respectively). After controlling for related confounding factors, the results of the multivariate Logistic regression analysis indicated that the following factors affected the total health literacy of middle school students: the investigated region (OR=1.20); school segment (OR=1.35); relationship with mother (OR=1.52); relationship with teacher (OR=2.20); number of close friends (OR=1.68); and health education course (OR=1.52) (P < 0.05). Conclusion The health literacy level of middle school students in Chongqing is relatively low. Therefore, it is necessary to focus on improving interactive health literacy in order to promote the healthy development of middle school students.
- Health education /
- Questionnaires /
- Regression analysis /
- Students

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表 1 不同组别中学生健康素养具备率比较

Table 1. Univariate analysis of health literacy of middle school students

组别	选项	人数	统计值	功能性健康素养	互动性健康素养	批判性健康素养	总健康素养
调查地区	九龙坡区	2 269		1 780(78.45)	1 238(54.56)	1 745(76.91)	1 627(71.71)
	巴南区	2 089		1 540(73.72)	900(43.08)	1 413(67.64)	1 333(63.81)
	綦江区	2 052		1 555(75.78)	1 135(55.31)	1 507(73.44)	1 454(70.86)
	云阳县	2 039		1 472(72.19)	972(47.67)	1 436(70.43)	1 328(65.13)
			χ²值	25.47	86.26	51.46	46.55
			P值	＜0.01	＜0.01	＜0.01	＜0.01
学校类型	城镇学校	4 504		3 430(76.15)	2 190(48.62)	3 307(73.42)	3 085(68.49)
	农村学校	3 945		2 917(73.94)	2 055(52.09)	2 794(70.82)	2 657(67.35)
			χ²值	5.51	10.12	7.08	1.26
			P值	0.02	0.00	0.01	0.26
学段	初中	4 065		3 017(74.22)	2 461(60.54)	2 994(73.65)	2 919(71.81)
	高中	4 384		3 330(75.96)	1 784(40.69)	3 107(70.87)	2 823(64.39)
			χ²值	3.41	332.37	8.13	53.26
			P值	0.07	＜0.01	0.00	＜0.01
性别	男	4 000		2 935(73.38)	2 173(54.33)	2 889(72.23)	2 711(67.78)
	女	4 449		3 412(76.69)	2 072(46.57)	3 212(72.20)	3 031(68.13)
			χ²值	12.40	50.64	0.00	0.12
			P值	＜0.01	＜0.01	0.98	0.73
父亲文化程度	高中及以上	2 366		1 847(78.06)	1 276(53.93)	1 796(75.91)	1 689(71.39)
	初中	3 858		2 884(74.75)	1 874(48.57)	2 755(71.41)	2 589(67.11)
	小学及以下	1 449		1 067(73.64)	713(49.21)	1 007(69.50)	964(66.53)
	不知道	679		471(69.37)	334(49.19)	473(69.66)	431(63.48)
	没有父亲	97		78(80.41)	48(49.48)	70(72.16)	69(71.13)
			χ²值	26.44	18.11	24.88	22.13
			P值	＜0.01	< 0.01	＜0.01	＜0.01
母亲文化程度	高中及以上	1 916		1 494(77.97)	1 050(54.80)	1 473(76.88)	1 387(72.39)
	初中	3 465		2 656(76.65)	1 810(52.24)	2 535(73.16)	2 399(69.24)
	小学及以下	2 204		1 616(73.32)	971(44.06)	1 503(68.19)	1 423(64.56)
	不知道	756		504(66.67)	363(48.02)	515(68.12)	460(60.85)
	没有母亲	108		77(71.30)	51(47.22)	75(69.44)	73(67.59)
			χ²值	46.28	57.08	46.79	49.11
			P值	＜0.01	＜0.01	＜0.01	＜0.01
父母关系	好	6 573		5 040(76.68)	3 515(53.48)	4 901(74.56)	4 659(70.88)
	中等	1 484		1 033(69.61)	576(38.81)	953(64.22)	867(58.42)
	差	392		274(69.90)	154(39.29)	247(63.01)	216(55.10)
			χ²值	38.36	123.85	81.89	117.51
			P值	＜0.01	＜0.01	＜0.01	＜0.01
与父亲关系	好	6 438		4 922(76.45)	3 490(54.21)	4 849(75.32)	4 591(71.31)
	中等	1 699		1 197(70.45)	644(37.90)	1 059(62.33)	973(57.27)
	差	312		228(73.08)	111(35.58)	193(61.86)	178(57.05)
			χ²值	26.61	170.82	130.29	139.44
			P值	＜0.01	＜0.01	＜0.01	＜0.01
与母亲关系	好	6 987		5 355(76.64)	3 702(52.98)	5 212(74.60)	4 946(70.79)
	中等	1 273		878(68.97)	470(36.92)	775(60.88)	697(54.75)
	差	189		114(60.32)	73(38.62)	114(60.32)	99(52.38)
			χ²值	56.58	121.58	114.57	148.72
			P值	＜0.01	＜0.01	＜0.01	＜0.01
家庭经济	好	1 264		972(76.90)	819(64.79)	995(78.72)	945(74.76)
	中等	6 003		4 521(75.31)	2 960(49.31)	4 334(72.20)	4 089(68.12)
	差	1 182		854(72.25)	466(39.42)	772(65.31)	708(59.90)
			χ²值	7.47	164.49	54.70	62.21
			P值	0.02	＜0.01	＜0.01	＜0.01
学习成绩	好	2 192		1 703(77.69)	1 213(55.34)	1 674(76.37)	1 591(72.58)
	中等	3 132		2 368(75.61)	1 627(51.95)	2 313(73.85)	2 174(69.41)
	差	3 125		2 276(72.83)	1 405(44.96)	2 114(67.65)	1 977(63.26)
			χ²值	16.91	61.29	55.50	56.19
			P值	＜0.01	＜0.01	＜0.01	＜0.01
与老师关系	好	4 675		3 629(77.63)	2 781(59.49)	3 649(78.05)	3 486(74.57)
	中等	3 574		2 587(72.38)	1 399(39.14)	2 345(65.61)	2 159(60.41)
	差	200		131(65.50)	65(32.50)	107(53.50)	97(48.50)
			χ²值	39.93	361.09	191.95	222.10
			P值	＜0.01	＜0.01	＜0.01	＜0.01
亲密朋友数量/个	≥6	2 207		1 703(77.16)	1 387(62.85)	1 727(78.25)	1 660(75.22)
	3~5	3 497		2 663(76.15)	1 738(49.70)	2 579(73.75)	2 415(69.06)
	1~2	2 464		1 786(72.48)	1 023(41.52)	1 640(66.56)	1 513(61.40)
	0	281		195(69.40)	97(34.52)	155(55.16)	154(54.80)
			χ²值	21.01	243.45	124.19	126.26
			P值	＜0.01	＜0.01	＜0.01	＜0.01
健康教育课程	每周≥2节	1 822		1 411(77.44)	1 105(60.65)	1 410(77.39)	1 352(74.20)
	每周1节	2 348		1 771(75.43)	1 349(57.45)	1 752(74.62)	1 687(71.85)
	2周1节	414		314(75.85)	215(51.93)	302(72.95)	299(72.22)
	无	3 865		2 851(73.76)	1 576(40.78)	2 637(68.23)	2 404(62.20)
			χ²值	9.29	266.76	61.77	111.29
			P值	0.03	＜0.01	＜0.01	＜0.01
注： ( )内数字为具备率/%。

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表 2 重庆市中学生健康素养具备情况多因素Logistic回归分析(n=8 449)

Table 2. Multivariate Logistic analysis of health literacy of middle school students in Chongqing(n=8 449)

自变量	选项	功能性健康素养		互动性健康素养		批判性健康素养		总健康素养
自变量	选项	β值	OR值 (OR值95%CI)	β值	OR值 (OR值95%CI)	β值	OR值 (OR值95%CI)	β值	OR值 (OR值95%CI)
调查地区	九龙坡区	0.27	1.31(1.13~1.51)^**	0.17	1.18(1.03~1.36)^*	0.19	1.20(1.04~1.39)^*	0.18	1.20(1.04~1.38)^*
	巴南区	0.02	1.03(0.89~1.18)	-0.14	0.87(0.76~1.00)^*	-0.17	0.85(0.74~0.97)^*	-0.07	0.93(0.81~1.07)
	綦江区	0.17	1.19(1.03~1.37)^*	0.42	1.52(1.33~1.74)^**	0.17	1.18(1.03~1.36)^*	0.30	1.35(1.18~1.55)^**
学校类型	城镇学校	—	—	-0.19	0.83(0.75~0.91)^**	0.10	1.11(1.00~1.23)^*	—	—
学段	初中	—	—	0.75	2.11(1.92~2.32)^**	—	—	0.30	1.35(1.23~1.49)^**
性别	男	-0.20	0.82(0.74~0.91)^**	0.26	1.30(1.19~1.43)^**	—	—	—	—
父亲文化程度	高中及以上	—	—	-0.27	0.77(0.49~1.20)	—	—	—	—
	初中	—	—	-0.36	0.70(0.45~1.09)	—	—	—	—
	小学及以下	—	—	-0.13	0.88(0.56~1.37)	—	—	—	—
	不知道	—	—	-0.32	0.73(0.45~1.18)	—	—	—	—
母亲文化程度	高中及以上	0.13	1.14(0.73~1.77)	0.16	1.17(0.77~1.79)	0.03	1.03(0.66~1.60)	-0.08	0.93(0.60~1.43)
	初中	0.13	1.14(0.74~1.76)	0.15	1.16(0.77~1.76)	-0.06	0.94(0.61~1.45)	-0.16	0.85(0.56~1.30)
	小学及以下	-0.00	1.00(0.65~1.54)	-0.06	0.94(0.62~1.43)	-0.20	0.82(0.53~1.26)	-0.26	0.77(0.50~1.18)
	不知道	-0.32	0.73(0.46~1.14)	-0.13	0.88(0.56~1.39)	-0.27	0.77(0.49~1.21)	-0.54	0.59(0.38~0.92)^*
父母关系	好	0.09	1.10(0.86~1.40)	—	—	—	—	—	—
	中	-0.09	0.92(0.71~1.18)	—	—	—	—	—	—
与父亲关系	好	—	—	0.49	1.64(1.26~2.12)^**	0.18	1.20(0.91~1.57)	0.17	1.18(0.90~1.54)
	中	—	—	0.11	1.12(0.86~1.47)	-0.07	0.93(0.71~1.21)	-0.07	0.94(0.72~1.22)
与母亲关系	好	0.49	1.63(1.17~2.29)^**	—	—	0.23	1.26(0.90~1.76)	0.42	1.52(1.09~2.12)^*
	中	0.33	1.39(1.00~1.94)	—	—	0.00	1.00(0.72~1.40)	0.09	1.10(0.79~1.53)
家庭经济	好	—	—	0.43	1.53(1.27~1.84)^**	0.25	1.28(1.06~1.55)^*	—	—
	中	—	—	0.14	1.14(1.00~1.32)	0.07	1.08(0.93~1.24)	—	—
学习成绩	好	—	—	—	—	0.17	1.18(1.04~1.35)^*	—	—
	中	—	—	—	—	0.14	1.15(1.02~1.29)^*	—	—
与老师关系	好	0.33	1.40(1.02~1.91)^*	0.89	2.44(1.76~3.39)^**	0.65	1.91(1.41~2.60)^**	0.79	2.20(1.63~2.98)^**
	中	0.16	1.18(0.86~1.60)	0.36	1.43(1.03~1.98)^*	0.30	1.35(1.00~1.82)	0.39	1.48(1.10~1.99)^*
亲密朋友数量/个	≥6	0.22	1.24(0.94~1.65)	0.74	2.10(1.58~2.77)^**	0.70	2.00(1.53~2.62)^**	0.52	1.68(1.29~2.20)^**
	3~5	0.15	1.17(0.89~1.53)	0.39	1.48(1.13~1.95)^**	0.54	1.72(1.33~2.23)	0.31	1.37(1.06~1.77)^*
	1~2	0.01	1.01(0.77~1.33)	0.22	1.25(0.94~1.65)	0.32	1.38(1.06~1.78)^*	0.09	1.10(0.85~1.43)
健康教育课	每周≥2节	—	—	0.58	1.79(1.58~2.02)^**	0.35	1.42(1.24~1.62)^**	0.42	1.52(1.33~1.72)^**
	每周1节	—	—	0.51	1.67(1.49~1.86)^**	0.20	1.22(1.09~1.38)^**	0.32	1.37(1.22~1.54)^**
	2周1节	—	—	0.35	1.41(1.14~1.75)^**	0.12	1.12(0.89~1.42)	0.36	1.43(1.13~1.80)^**
注：—表示变量未被选入模型；P＜0.05，*P＜0.01；自变量分别以云阳县、农村学校、高中、女生、没有父亲、没有母亲、父母关系差、与父亲关系差、与母亲关系差、家庭经济差、学习成绩差、与老师关系差、亲密朋友数量为0、每周无健康教育课程为参照。

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